Cost-effectiveness of bazedoxifene versus raloxifene in the treatment of postmenopausal women in Spain.

Abstract

BACKGROUND:

The purpose of this study was to assess the cost-effectiveness of bazedoxifene and raloxifene for prevention of vertebral and nonvertebral fractures among postmenopausal Spanish women aged 55-82 years with established osteoporosis and a high fracture risk.

METHODS:

A Markov model was developed to represent the transition of a cohort of postmenopausal osteoporotic women through different health states, ie, patients free of fractures, patients with vertebral or nonvertebral fractures, and patients recovered from a fracture. Efficacy data for bazedoxifene were obtained from the Osteoporosis Study. The perspective of the Spanish National Health Service was chosen with a time horizon of 27 years. Costs were reported in 2010 Euros. Deterministic results were presented as expected cost per quality-adjusted life-year (QALY), and probabilistic results were represented in cost-effectiveness planes.

RESULTS:

In deterministic analysis, the expected cost per patient was higher in the raloxifene cohort (€13,881) than in the bazedoxifene cohort (€13,436). QALYs gained were slightly higher in the bazedoxifene cohort (14.56 versus 14.54). Results from probabilistic sensitivity analysis showed that bazedoxifene has a slightly higher probability of being cost-effective for all threshold values independent of the maximum that the National Health Service is willing to pay per additional QALY.

CONCLUSION:

Bazedoxifene was shown to be a cost-effective treatment option for the prevention of fractures in Spanish women with postmenopausal osteoporosis and a high fracture risk. When comparing bazedoxifene with raloxifene, it may be concluded that the former is the dominant strategy.

• Authors: Josep Darbà, Nuria Pérez-Álvarez, Lisette Kaskens, Susana Holgado-Pérez, Jill Racketa, Javier Rejas
• Journal: ClinicoEconomics and outcomes research : CEOR (Clinicoecon Outcomes Res) Vol. 5 Pg. 327-36 ( 2013) ISSN: 1178-6981 [Print] New Zealand
• PMID: 23882153 (Publication Type: Journal Article)